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Case Reports
. 2016 Jan-Mar;26(1):92-4.
doi: 10.4103/0971-3026.178349.

Congenital intrahepatic portosystemic shunts: Imaging findings and endovascular management

Rajsekar Chandrasekharan  1 , Sreekumar K Pullara  1 , Tixon Thomas  1 , Nazar Puthukudiyil Kader  1 , Srikanth Moorthy  1
Affiliations
Case Reports

Congenital intrahepatic portosystemic shunts: Imaging findings and endovascular management

Rajsekar Chandrasekharan et al. Indian J Radiol Imaging. 2016 Jan-Mar.

Abstract

We present two cases of congenital intrahepatic portosystemic shunts in which the right portal vein directly communicated with the inferior venacava (IVC) in one patient and with the hepatic vein in the other. Multiple hepatic nodules consistent with focal nodular hyperplasia (FNH) were seen in the first patient. The second patient presented with recurrent history of hepatic encephalopathy. Percutaneous transhepatic embolization was performed using coils and Amplatz device following which she completely recovered.

Keywords: Amplatzer device; amplatz vascular occluder device; congenital portosystemic shunts; hepatic encephalopathy; hypertrophied hepatic artery; intrahepatic portosystemic shunts; portal vein hypoplasias.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1 (A-C)
Figure 1 (A-C)
An 8-year-old female child with multiple focal nodular hyperplasia-like lesions. Axial CT image in portal venous phase (A) shows multiple minimally enhancing lesions in both lobes of liver (long white arrow) (B) Abnormal portal venous channel connecting the right portal vein and IVC (curved arrow), consistent with portocaval shunt (C) Heterogeneous lesion at segment VI (black arrow) and hypertrophied hepatic artery (short white arrow)
Figure 2 (A-E)
Figure 2 (A-E)
A 36-year-old female presented with encephalopathy. Axial CT image in portal phase (A) shows the anterior branch of the right portal vein joining with the right hepatic vein (black arrow). Portogram (B) showing venous sac connecting the portal vein (white arrow) with the right hepatic vein (black arrow) (C) Introduction of the Amplatz vascular device (arrow) through 6F vascular sheath (D) Deployment of metallic coils (arrow) proximal to the Amplatz occluder device. Post embolization angiogram (E) showing occlusion of the portosystemic venous shunt
See this image and copyright information in PMC

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